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����� <br /> . <br /> APPLICATION FOR SANITATION PERMIT <br /> (Complete in,Dup|�a0� <br /> ` <br /> Ag <br /> plication n <br /> 6en,�vmo6nfo ��� S� JuoquinLoca| Hca|1hD|o+� � construct^ . � application i, made in compliance with County Ordinance No. 549. <br /> .~~ <br /> / '`""~�^^ AND ���". <br /> Address.--_-----_-------~� �*~. �G�. _____._..___..__._________' ,.___- ~'=� <br /> Contractor's Name---------------------------------------------------------------------------------------------------`--------------------------------------------- Phonu--.----------..-' <br /> |nsta|lation will serve, Residence Apartment House' E] Commercial 0 7ra||er Couirt � Othe.r <br /> Number of living units: �~ 66e, ofbednvomy um�- ~"mbvr of baths Lot .5p.o _-- <br /> _ <br /> --_ <br /> --------- <br /> Wafer Supply: Public system � Communi+y <br /> system E] Private F] � <br /> Character mfsoil foa depth mf3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam Clay E] /\do6o ,dpon F] <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank �r �no�ppp| pe,m��w� � public �o uvaUa�kyv°lthYn ��� 6ew| <br /> ' ''> <br /> ' <br /> Septic Tank: Distance from nearest <br /> �eU- --'Dixtvnce {oun-6o+ion- �� �� w� ui� �� <br /> �.-»*.. � �.-__No. of compartments = --'~�p""'Y-m �'� �--»��' O�X qu/d depth <br /> � <br /> -Cesspool: Distance from nearest well------------------Distance from foundation �Univ-g material------------------------------------- <br /> [-I. <br /> _________ <br /> [] Diameter <br /> 3�e� D�me*a,_-..__-__---..__.Deo+k .____-.-___-.-__--_ ' <br /> Dis+ num from nearest well __'---_.'--__.-__-''Distance fn,m.neoras building''-.'-_-'-_.'_-'_ <br /> [] Distance to nearest lot |ine__------_--_______ & �� <br /> ~" <br /> Pit:' Distance to ^eo,asweL-'--__''Disfonce from foundation--------------------Distance to nearest lot line-__-'- ^ <br /> [] 'N6m6orofpits----------------------Lining mator|aL___.__.Sizu: Diameter-----------------------Dept6'-_..__..___---- <br /> | <br /> |, , �� --� -'-- <br /> ~~- <br /> to '~~'~~' <br /> of <br /> Length line----. <br /> �K Number of ||n ° ��nr � ---------------------- <br /> Type <br /> '���-��� <br /> Tvoo of filter material . x ,..z �apof �|+ar mmfo�� <br /> ------ <br /> Remodeling <br /> - <br /> and/or repairing (J6oc,bia) <br /> ` -.------_-..-----_------------_-------.-----_---.--_--_--.-_----.------_-- -_---------. --- <br /> . � ' _ <br /> | | hereby <br /> ~_ . . _ ' ela��o��to wells, buildings,-- etc., -- dance with San Joaquin County <br /> ordinances, State laws, and rules and regulations of the San Joaquin Local Health Dis+rief. <br /> -- _filed with^' this~ ~rr'^="°'v' . <br /> | <br /> FOR DEPARTMENT USE ONLY <br /> ' <br /> APPLICATION ACCEPTED BY-------- ---------------------- <br /> REV|E\�ED BY___'-__-'_-_.'_-''_-'-__--'_---_.'—'-''--'''-_-��-_ DATE y /' �'/--- / <br /> BUILDINGPERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE--------------------------- <br /> ----------------- <br /> -------------- <br /> Alterations and/or recommendations:-'---------_--.--------_--.--------_.---_.----_.._.________.________ <br /> '-_-_-_-_..___--___._-__-.-__-_.__-_-__--__-.__--___--___-____.__--_-_----------------------------------- <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ <br /> � -'-___-_ ---------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------''------------------------- <br /> ----'��---------------- ����-----------'---------------'' --------------------------'����----'---------''-----------------------------------'------------------'�'-----------` <br /> PERM|T No�.�����'--. }3SUED'����.. �`��--��--..(Do+e) FINAL INSPECTION B� ____------------------- <br /> Date <br /> ______ <br /> . ' . <br /> Dot,'''----------- <br /> SAN JOAQUIN <br /> ----"SANJ[AQU|N LOCAL HEALTH DISTRICT ' <br /> 130 South American Street - <br /> Stockton, California�-�-�wv�umw�zv � <br /> � <br />